Lymphoma

Question 1

What is hodgkins lymphoma?

Answer 1

Hodgkin’s lymphoma (HL), also referred to as Hodgkin’s disease, is an uncommon haematological malignancy arising from mature B cells.

Question 2

What is non hodgkins lymphoma?

Answer 2

Non-Hodgkin’s lymphomas (NHL) are a heterogeneous group of malignancies of the lymphoid system.

Question 3

What are the risk factors of hodgkins lymphoma?

Answer 3

> EBV
> FHx
> young adults from higher socioeconomic class
> HLA types
> Jewish ancestry

Question 4

What are the risk factors of non hodgkins lymphoma?

Answer 4

> Age >50 yrs
> Male 
> Immunocompromised
> EBV
> HTLV-1
> HHV8
> H pylori
> Coeliac disease
> HIV
> HCV
> Sjorgen's syndrome
> Wiskott Aldrich
> Ataxia- telangiectasia

Question 5

What are the signs and symptoms of hodgkin’s lymphoma?

Answer 5

> lymphadenopathy
> fever
> night sweats 
> weight loss 
> dyspnoea
> cough
> chest pain 
> SVC obstruction
> abdominal pain
> generalised pruritis
> alcohol induced pain
> hepatomegaly/ splenomegaly
> Tonsillar enlargement

Question 6

What are the signs and symptoms of non-hodgkin’s lymphoma?

Answer 6

> Night sweats
> Weight loss
> Fatigue/ malaise
> fever
> lymphadenopathy
> splenomegaly

Question 7

What is the epidemiology of hodgkins and non hodgkins lymphoma?

Answer 7

HL is an uncommon malignancy. In the UK, there were 2086 new cases of HL between 2014 and 2016.

In the UK, 13,682 people were diagnosed with NHL in 2015.

Question 8

What investigations would you do for hodgkins lymphoma?

Answer 8

> FBC (low Hb/ plt)
Metabolic panel (normal)
ESR (high)
CXR (mediastinal mass/ lymphadenopathy)
PET-CT (bright spots)
gallium scan (nright spots)
Contrast CT neck/ chest/ abdo/ pelvis (enlarged lymph nodes)
Excisional lymph node biopsy (Hodgkins cells)
immunohistochemical studies

Question 9

What investigations would you do for non hodgkins lymphoma?

Answer 9

> FBC (pancytopenia)
> blood smear (left shift and nucleated RBC)
> lymph node biopsy (pos)
> skin biopsy (pos)
 > bone marrow biopsy (pos)
> basic metabolic panel
> liver function tests (elevated)
> LDH (elevated)